The Inflation Reduction Act capped insulin prices at $35 a month for Medicare beneficiaries. (Photo Illustration by Spencer Platt/Getty Images)
Many of us have heard of Project 2025, the blueprint for a second Donald Trump presidency written by 140 of his former aides. While there are many concerning elements of this plan, as a doctor, one of the more concerning ones is the plan to repeal the Inflation Reduction Act (IRA).
The IRA is a landmark piece of legislation that has brought significant relief to countless Americans struggling with high health care costs. As a physician, I have witnessed firsthand the profound impact this legislation has had on patients. This is why the looming threat to repeal the IRA, spearheaded by Donald Trump and his allies through Project 2025, is so alarming. Repealing the IRA would reverse the progress we’ve made and exacerbate the health and financial struggles of millions of Americans.
Before the IRA, 1 in 5 older adults skipped or delayed medications because of cost. The IRA has been a game-changer for those patients. It capped insulin prices at $35 a month for Medicare beneficiaries, providing crucial savings for the 1.5 million Americans who rely on this life-saving drug. These caps mean huge savings for senior patients–with each individual saving an average of $501 annually.
Additionally, the IRA has put a $2,000 annual cap on out-of-pocket prescription drug costs for Medicare recipients, set to begin in 2025. This provision will alleviate the financial burden on nearly 18.7 million Americans who currently face steep drug costs. The new cap ensures that seniors are not forced to choose between their health and their financial stability.
The IRA also empowered Medicare to negotiate lower prescription drug prices, a common-sense measure supported by a vast majority of Americans. This negotiation power tackles the issue of skyrocketing drug prices at its source, holding pharmaceutical companies accountable. The first ten drugs selected for negotiation, benefiting around 9 million Americans, will see price reductions starting in 2026.
Beyond Medicare, the IRA extended enhanced tax credits for those purchasing health insurance through the Affordable Care Act (ACA) Marketplace. This extension has helped over 14.2 million Americans afford their premiums, with 91% of ACA plan enrollees receiving these tax credits in 2024. This support is critical for individuals and families who might otherwise be priced out of necessary coverage.
Despite these significant benefits, the IRA is under threat. Project 2025, backed by Donald Trump and his allies, aims to dismantle these protections. If successful, this would mean a return to unaffordable insulin prices, uncapped out-of-pocket prescription drug expenses, and the end of Medicare’s ability to negotiate drug prices. The repeal would also eliminate the extended tax credits, leading to higher premiums and reduced coverage for millions.
The consequences of such actions would be devastating. With 1 in 4 Americans struggling to afford health care, repealing the IRA would not only harm individual health but also lead to broader public health issues. The financial strain on families would grow, pushing more people into poverty and deepening health disparities.
Rather than overturning the IRA, we should be building upon it. Last year, the Nevada Legislature took action to do just that, passing Assembly Bill 250 to extend the cost reductions from Medicare-negotiated prescription drugs to all Nevadans. Unfortunately Governor Joe Lombardo vetoed the legislation, but physicians are urging lawmakers to pass it again and to encourage Gov. Lombardo to sign it next time.
As a physician, I urge policymakers at the state and federal levels to recognize the critical importance of the IRA and protect and build upon it. We cannot allow Project 2025 to undo the progress we have made. Protecting the IRA is not just a matter of policy; it is about safeguarding the health and financial stability of millions of Americans. We must stand united to ensure that these life-saving provisions remain intact, providing affordable health care for all.
The IRA is more than just legislation; it is a lifeline for millions of patients. As a physician, I will work to defend it against those who would turn back the clock on affordable health care, and I urge others to join me. The health and well-being of our nation depend on it.